Rom Houben

Rom Houben is a Belgian man presumed comatose and in a vegetative state for 23 years after a near-fatal automobile accident, but according to several of his caregivers, was conscious and paralyzed during the entirety of his hospital stay.[1][2][3] In 2010, the claim was rejected when communication could not be repeated with a different facilitator and by hiding the object to be identified from the view of the facilitator.[4]

Houben's case is used to question the current methods of diagnosing vegetative state and to arguments against withholding care from such patients.[5][12] However, some bioethicists believe that the case, if confirmed, may provide stronger arguments for withdrawing or withholding from vegetative patients.[9]

While Houben was diagnosed in 2006, his case, first reported in a BMC Neurology paper in July 2009[12] without him being named, was only brought to wider public attention after German weekly magazine Der Spiegel ran a story on it in November 2009 which was subsequently picked up by media outlets around the world, receiving extensive coverage.[13][14][15]

Additionally, Arthur Caplan, a bioethics professor at the University of Pennsylvania, has claimed that the statements Houben allegedly made through his facilitator seem unnatural for someone disabled and unable to speak for decades.[13][18] Through Wouters, Houben is quoted as saying "Now I can communicate and talk via facilitated communication. Not everyone believes in this form of communication. It is a controversial method but, for me, it is vital to life. At last, my views can be heard and my feelings expressed."[19]

Initially, Dr. Laureys said that he had verified that the facilitated communication was genuine, by showing Houben objects when the facilitator was not present in the room, and later asking Houben to recall those objects.[19] Dr. Novella suggested that Dr. Laureys had not used proper controls.[11]

In an interview with the Belgian newspaper De Standaard,[20] Laureys stated that he was not involved in the choice of communication method and refused to comment on its validity. He even claimed to be "a skeptic [himself]" and acknowledged that "the bad reputation of some forms [of facilitated communication] is justified". He also claimed that Houben's case was only made public because Der Spiegel wanted to report on his study and was looking for a "human element" to the story: "I knew that Rom and his family were willing to collaborate because they had done so before [for a Flemish TV channel]." However, he also criticized some of the negative feedback for "judging the evidence only on the basis of some video footage" and declared that "given time, we will look scientifically into the different ways of communication. For us, this seems to be the proper way."

Laureys later concluded that messages attributed to Houben through Wouters' facilitation were not, in fact, coming from Houben after all. After the early tests, further testing met with resistance. Using a different facilitator, subsequent testing under properly controlled conditions in which fifteen objects which were shown to Houben over a period of weeks was performed, Houben was unable to communicate knowledge of any of the objects which had been shown to him during the facilitator's absence.[4][21] Dr. Steven Novella attributed Dr. Laureys's prior error to likely insufficient experience with facilitated communication.[4]